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INDONESIA
journal of internal medicine
Published by Universitas Udayana
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
Medicine & Pharmacology
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Articles 10 Documents
 1 
Search results for , issue "Vol. 7, No. 3 September 2006" : 10 Documents clear
PERAN BIOPSI HEPAR DALAM MENEGAKKAN DIAGNOSIS IKTERUS OBSTRUKTIF EKSTRA HEPATIK Sherly M, Yuliana; Widita, Haris; Ardita, IG; Soemohardjo, Soewignjo
journal of internal medicine Vol. 7, No. 3 September 2006
Publisher : journal of internal medicine

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Abstract

Obstructive icterus is caused by 2 major group from the intrahepatic and ekstrahepatic and ekstrahepatic. Generally toconfirm clinical diagnosis is done with USG imaging. In which USG easily could differentite the cause of the bile duct (accuracy90%). The mothode of biopsy is only to evaluate the intrahepatic icterus. In certain cases, it is not easy to confirm either itsobstructive icterus extraheaptic or intrahepatic, as the bile duct smetimes to seen clearly on the USG examination, which is toassure the side of obstructive because the distal part of the bile duct difficult to be seen in 30%-50% cases until hepatic biopsy isreduced. Meanwhile the histopatology appearance of extrahepatic icterus are marked by classis changes known as ductulerreaction, which as the oedema of connective tissue, ductular proliferation and neutrofil infiltration. There by here, we report thecase of a man, 53 years old with obstructive icterus, where in the beginning is suspected as intrahepatic cholestasis and the causeof extrahepatic icterus is unknown, then the diagnosis was confirmed with histopatology examination.
RANDOMIZED CLINICAL TRIAL OF OMEPRAZOLE AND RANITIDINE USING INDONESIAN TRANSLATED NEPEAN DYSPEPSIA INDEX Arinton, I Gede; Samudro, Pugud; Sutrisna, Eman; IDN, Wibawa
journal of internal medicine Vol. 7, No. 3 September 2006
Publisher : journal of internal medicine

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Abstract

In patients with dyspepsia, a common initial management strategy in primary care is to prescribe a course ofempiric antisecretory therapy. Ranitidin and omeprazole as antisecretory agents have been proven effective fortreatment of dyspepsia. This research was aimed to evaluate the effect of omeprazole and ranitidine by using NepeanDyspepsia Index (NDI) which was translated and validated in Indonesian language. Fifty healthy persons were askedto complete the Indonesia translated NDI(NDII) and Short Form(SF)- 36, which was previously validated. Cronbach' salpha and test-retest were performed for reliability analysis. Spearman's rank correlation was used to assess validity. P-value <0.03 was considered statistically significant. The results concluded that NDIl can be used in dyspepsia patientswho understand Indonesian language. The number of 104 subjects with a clinical diagnosis of dyspepsia according tothe inclusion and exclusion criteria were recruited and randomized to receive ranitidine 150 mg twice daily andomeprazole 20 mg twice daily. Symptoms of dyspepsia were evaluated by using NDIl at baseline one week aftertreatment. The outcomes of omeprazole and ranitidine were evaluated by comparing improved NDIl score in 5domains (tension, activities, eating/drinking, knowledge/control and work/study). The mean of age in the subjects was47 years old that consisted of 36% male. After one week treatment, the NDIl dyspepsia patients score in omeprazoletreated group was not significantly different from that in ranitidine treated group. The effect of omeprazole was notbetter than ranitidine when it was given as empirical treatment for dyspepsia patients in primary care.
PENANGANAN DISPEPSIA PADA LANJUT USIA Wibawa, I Dewa Nyoman
journal of internal medicine Vol. 7, No. 3 September 2006
Publisher : journal of internal medicine

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Abstract

In elderly patients with dyspeptic syndrome, organic causes more prevalence rather than fungsional related disorders. Theuse of Nonsteroid Anti Inflammatory Drugs (NSAIDs) and H. pylori infection play as important role as causes of organicdyspepsia in eldery patients. There are some changes in upper gastrointestinal tract which is related to aging process, especially inmucosal defance mechanism. The changes in aggressive factors are only a few. Diagnostic approach with endoscopic examinationis necessary in eldery patients with dyspeptic syndrome to role out the possibility of organic origin. The management of dyspepsiain eldery patients needs comprehensive approach because clinical presentation usually asymptomatic, the use of polypharmacy,co-morbidity, and the probability of organic origin as a cause needs to be proved since the beginning.
HUBUNGAN JUMLAH FOLIKEL ANTRAL DENGAN RESPONS OVARIUM TERHADAP STIMULASI OVULASI Adnyana, IB Putra
journal of internal medicine Vol. 7, No. 3 September 2006
Publisher : journal of internal medicine

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Abstract

Recent studies show there is possibility to predict ovarian response to ovulation stimulation. Several possiblepredictor factors are age, ovarian volume, antral follicle count (AFC), ovarian stroma blood flow, and hormonalmarkers like Follicle Stimulating Hormone (FSH), Estradiol (E2) and Inhibin B. AFC is a simple examination forovarian reserve. Compared with hormonal markers, AFC more simply, relatively less costly and only using ultrasoundmachine, which widely available and the result could be obtained in timely manner. To understand relationshipbetween AFC and ovulation stimulation response. All women who joined IVF program with short protocol stimulationfrom January 2005 until May 2006 were enrolled into the study. Data collected were AFC day two, mature folliclecount, total oocyte count, mature oocyte count, and total gonadotrophin dose. Data were analyzed with Kendall’scorrelation test to show relationship. This study shows statistically significant correlations between AFC with maturefollicle count (r=0,329; p=0,037), total oocyte count (r=0,506; p=0,001), mature oocyte count (r=0,492; p=0,002), andtotal gonadotrophin dose (r=-0,477; p=0,002). This study shows there are statistically significant correlations betweenAFC with ovarian response to ovulation stimulation and the cutoff point of AFC is 4,5.
ADIPONECTIN ACTIVITY IN ACUTE VIRAL HEPATTOBI Suryadarma, I Gusti Agung
journal of internal medicine Vol. 7, No. 3 September 2006
Publisher : journal of internal medicine

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Abstract

The mechanisms of hepatocellular necrosis in acute viral hepatitis, primarily through cytopathic immune mechanisms,however the processes of hepatic parenchyma necrosis also might be secondarily involved the roles of cytopathic non-immunemechanisms. Once of the defend mechanisms to the hepatic viral infection is through the releases of adiponectin. Adiponectin is ahormone secreted by adipocytes. The protective effect of adiponectin against liver injury likely involve multiple mechanisms,especially to the ability effects of adiponectin as a anti-inflammatory cytokines. Thus, decreased of the adiponectin concentration<10 mg/dl in the acute viral hepatitis, especially Hepatitis B and C perhaps as the early biomarkers of possibility progression tothe chronic hepatitis.
PENATALAKSANAAN PASIEN DIABETES MELITUS DI POLIKLINIK RUMAH SAKIT SANGLAH DENPASAR Adnyana, Losen; -, Hensen; Gde Budhiarta, Anak Agung
journal of internal medicine Vol. 7, No. 3 September 2006
Publisher : journal of internal medicine

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Abstract

A cross-sectional study was conducted from March until May 2003 among 100 diabetic patients, registered inDiabetic Clinic, Department of Internal Medicine Sanglah Hospital for management of diabetes for more than 12months. Primary objective was to evaluate diabetes control, diabetes management and late complications status in thediabetic population managed by Diabetic Clinic as urban health care clinics. The subjects were 65% men and 35%women with mean of age 59.4 years and known having diabetes since 1-5 years (mean 2.1 years). Samples consist of4% type-1 diabetes; 95% type-2 diabetes and 1% gestational diabetes. Antidiabetic medication were sulfonylurea67%; metformin 55%; insulin 26% and others (glucosidase inhibitors, thiazolidenedione and others) were 0%.According to the level of AIC, lipid profile and blood pressure, 40% (AIC < 6.5%); 50% (HDL-chol >-45 mg/dl);27.0% (LDL-cho! < 100 mg/dl); 67.6% (triglyceride < 150 mg/dl) and 23% (blood pressure < 130/80 mmHg) werecategorized as good diabetic controls. Large proportion of poor diabetic controls partly may be due to low proportionof education days received on diabetes in the past year (57% have only I education day and 32% with zero educationday). This condition also impact on lifestyle modification where 63% not regularly and 14% never follow the diet and50% never . exercise. Also 12% still smoker and 4% sti 11 consume alcohol on a regu lar basis. Micral test to detectmicroalbuminuria as an early I phase of diabetic nephropathy were not commonly used (7%), and dipstick to detectmakroalbuminuria (99%). Blood test for serum creatinin showed 89% with serum creatinin <2 mg/dl and 11% withserum creatinin >2 mg/dl. Another chronic complication were neuropathy (10.1%); cataract (10.4%); backgroundretinopathy (8.6%), healed ulcer (3%), stroke (2%), leg amputation (1%), absence of foot pulse (1%), acuteulcer/gangrene (1%), myocard infard/CABG/angioplasty (1%).
PERAN SISTEM FlBRINOL1S1S PADA BERBAGAI PROSES FISIOLOGIS DAN PATOLOGIS Gde Budhiarta, Anak Agung
journal of internal medicine Vol. 7, No. 3 September 2006
Publisher : journal of internal medicine

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Abstract

Plasminogen can be converted to plasmin either by t-PA or u-PA. A dual role for these pathways isnow well established where t-PA is involved in fibrin homeostasis and u-PA is primarily involved in cellmigration and tissue remodelling. Using this mechanism thrombolytic terapy of myocardial infarction andsome other thromboembolic diseases have been introduced. Thrombolytic therapy could be improved byearlier and accelerated treatment, the used of plasminogen activator with increased thrombolytic potencysuch as reteplase, tenetecplase and staphylokinase and the use of more specific and potent anticoagulant andantiplatelet agents. Increased activity of matrix metalloproteinases (MMPs) has been implicated innumerous disease processes, including tumor growth and metastases, arthritis, and periodontal disease. It isnow becoming increasingly clear that extracelluler matrix degradation by M M Ps is also involved in thepathogenesis of cardiovascular disease, including atherosclerosis, restenosis, dilated cardiomyapathi,andmyocardial infarction. Administration of synthetic MMP inhibitor in experimental animal models of; thesecardiovascular disease significantly inhibits the progression of respectivelyatherosclerotic lesion formation,neointima formation, left ventricular remodeling, pump dysfunction, and infarc healing.
TES PROVOKASI (TP) SEBAGAI UPAYA PENDEKATAN DIAGNOSIS DUGAAN ALERGI OBAT PADA SEORANG PENDERITA TB PARU YANG DITERAPI DENGAN OBAT ANTI TUBERKULOSA KATEGORI I Duarsa, Reny S.P.; Suryana, Ketut
journal of internal medicine Vol. 7, No. 3 September 2006
Publisher : journal of internal medicine

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Abstract

Drug allergy is an unpredictable adverse reaction which is based on immunologic reaction. This event accounts foraround 5 to 10 % of the total number of adverse reaction to drug events. Diagnostic approaches to drug allergy are based ondetailed anamnestic questions, chronology of events, physical diagnostics and are also supported by other examinations such asskin prick test, skin patch test, radioallergosorbens test (RAST) and drug provocation test (DPT). DPT is still the gold standard fordrug allergy test and is done if other tests cannot confirm a significant conclusion. Nonetheless, this procedure is a dangerouscourse of action. Hence close coordination with intensive care unit and retaining informed consent should be done ahead of time.In this paper, we will examine a specific case in which DPT test is used to find out the drug which had caused an allergic reaction.It is shown in this paper, we are able to conduct a safe diagnostic procedure as long as we take into consideration the risk andbenefit for each patient. In this paper, we also point out about indication, contraindication, when to perform the test, test method,interval - dose, test preparation, and what kind of conclusion could be taken from the test.
PENGARUH HIPERGLEMI TERHADAP PERAN SITOSKELETON (CYTOSKELETON) SEBAGAI JALUR TRANSDUKSI SIGNAL (SIGNAL TRANSDUCTION) Rudijanto, Achmad; Kalim, Handono
journal of internal medicine Vol. 7, No. 3 September 2006
Publisher : journal of internal medicine

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Abstract

Intracellular signal transduction occurs through cascades of reactions involving dozens of proteins that transmit signalsfrom the cell surface, through a crowded cellular environment filled with organelles and a filamentous cytoskeleton, to specifictarget. For most characterized signal transduction pathway, the initial signaling event and the end point are well known. In order tofully understand intracellular signal transduction, it is essential to know the intermediate signaling molecules and to understandhow information flows from one to the next. The cytoskeleton , an interconnected assembly of actin (microfilament), intermediatefilament and microtubule networks that extend throughout the entire cell, is involved in intracellular signal transduction.Individual proteins of the cytoskeleton might participate directly in signal transduction by linking two or more signaling proteinand might also provide a macromolecular scaffold, which spatially organizes components of a signal transduction cascade.Diabetes mellitus is an increasingly common disease. Absolute or relative deficiencies of insulin are common in this disease.Insulin has been suggested to play a key regulatory role in the functional organization of actin filaments. The microtubules are alsothe targets of insulin. A chronic insulin deficiency may could lead to impairment in the organization of the cytoskeleton. Thiscould entail a compromised or slower action of some activated enzymes in cells, affect to intracellular signal transduction.
PERAN PENURUNAN BERAT BADAN TERHADAP KADAR PLASMINOGEN ACTIVATOR-1 PADA OBESITAS ABDOMINAL Budhiarta, A.A.Gd.
journal of internal medicine Vol. 7, No. 3 September 2006
Publisher : journal of internal medicine

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Abstract

Analytical cross-sectional study involving 77 subjects (male 31, female 46) with abdominal obesity (Ab-Ob) and 27 subjects non obese (male 20; female 7), age between 30-60 years were conducted and continued withrandomized pre-post test control group study involving 66 subjects (male 25, female 41) with Ab-Ob recruitedfrom the analytical cross-sectional study. Using random permuted block 30 subjects ( male 12; female 18) weretreated with hypocaloric diet and regular physical exercise for 12 weeks and 36 subjects (male 13; female 23) ascontrols. Compare with non obese subjects there were higher levels of active PAI-1, insulin and HOMA-IR insubjects with Ab-Ob (p<0.001 ; p = 0.001 and p < 0.001 respectively). There were significant correlation betweenfasting insulin level and HOMA-IR with active PAI-1 ( r = 0.488, p <0.001 and r = 0. 543, p <0.001 respectively).Among treated group decreased in body weight 5.9 kg or 7.4% followed by decreased in WC ( p <0.001), insulin(p = 0.005), and active PAI-1 (p <0.001). Among treated group decreased in WC ( p<0.001), insulin (p = 0.001),and active PAI-1 ( p = 0.003) were higher than control group. There were positive correlation between decreasedbody weight ( r = 0.297; p <0,001), decreased decreased FBS ( r = 0.307 ; p = 0.012), decreased insulin (r =0.360 ; p = 0.003), with decreased active PAI-1. To test the independence of associations between decreased inactive PAI-1 and decreased body weight, fasting blood sugar and insulin levels during program, a multivariatelinear regression analysis was performed. Only decreased in body weight and decreased fasting blood sugarsignificantly and independently associated with decreased in active PAI-1 and accounted for 23.4% of the varianceof decreased in active PAI-1. Decreased body weight accounted for 17.1% and decreased fasting blood sugaraccounted for 6.3% of decreased in active PAI-1.

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